(A)
Center policies
and practices shall support parent preferences in infant feeding, including
breastfeeding and shall recognize the center for disease control's
determination that handling and storage of breast milk does not require the use
of universal precautions and that breast milk is not considered a biohazard.
Center policies and practices shall also support the introduction of solid
foods as long as developmentally appropriate and not detrimental to the health
of the child.

(B)
Each infant
shall be removed from his or her crib for all feedings. Infants shall be held
or fed sitting up for bottle feedings. At no time shall a bottle be propped for
an infant.

(C)
Infant food shall
be prepared and served in a manner appropriate to the developmental needs of
each child according to his stage of development.

(D)
Infants shall be served food in
conformity with dated written instructions from the parent or guardian or
physician. The instructions shall include amounts of food, type of food, and
feeding times and be updated as needed based upon the child's needs and
parent's instructions.

(E)
Should
the parent or guardian not provide instructions for the serving of food to
their infant, the infant shall be served food in amounts that meet the meal
pattern and quantity of the United States department of agriculture (USDA)
child and adult care food program child care component.

(F)
When infant formula is prepared by the
center, it shall be prepared according to the manufacturer's instructions or
instructions from the child's physician or advance practice nurse.

(G)
The center shall clean and sanitize all
surfaces just prior to preparing formula, breast milk or food. All equipment,
including bottles and nipples, shall be washed in a dishwasher or scrubbed with
hot water containing soap, thoroughly rinsed and boiled for one minute prior to
use or reuse. Handwashing facilities shall not be used for formula, breast milk
or food preparation or for rinsing or washing dishes and bottles.

(H)
Centers that care for infants shall have
available the appropriate commercially prepared formula for the infant in the
event that the parent or guardian does not provide a quantity of formula
sufficient to meet the infant's daily requirement. Formula beyond its
expiration date shall not be served.

(I)
The center shall develop and implement a
plan for the safe storage of food, formula and breast milk.

(1)
Open containers of ready to feed and
concentrated formula shall be covered, dated and refrigerated according to the
manufacturer's instructions. Prepared formula and food shall be discarded or
sent home daily if not used.

(2)
Until used, all formula or food shall be labeled with the child's name and date
of preparation and refrigerated immediately after preparation or upon arrival
if prepared by the parent or guardian, and sent home daily. Formula or food
that is commercially prepared may not be required to be refrigerated until
after opening and shall be stored and served according to the manufacturer's
instructions and the expiration date on the label and labeled with the child's
name and date of preparation.

(3)
If breast milk is provided by the parent or guardian, it shall be labeled with
the child's name, date expressed and the date of receipt. Centers shall follow
the chart below in regard to storing breast milk:

Breast milk storage guidelines

If breast milk is stored: Then keep it as long as:

at room temperature (up to 78 degrees Fahrenheit) 6 to 8 hours

in the refrigerator (39 degrees Fahrenheit or lower) up to 5
days counted from the day the breast milk was expressed

in a freezer compartment of a refrigerator with separate doors
(0 degrees Fahrenheit) 3 to 6 months

chest or upright deep freezer (- 4 degrees Fahrenheit) 6 to 12
months

(4)
If formula or
fluid breast milk is to be warmed, bottles shall be placed in a container of
hot, not boiling, water or be placed in a commercial bottle warmer. The
container of water shall be emptied and cleaned each day. The bottle shall be
shaken well, and the formula or breast milk temperature tested before feeding.
Frozen breast milk shall be thawed under cold running water or in the
refrigerator.

(5)
Microwave ovens
shall not be used for heating formula, breast milk or other liquids.

(6)
Infant bottles, formula, breast milk and
food shall be readily available to staff. Staff/child ratios and supervision
shall be maintained when staff are obtaining, preparing or warming bottles or
food.

(7)
The unused portion of
formula, breast milk or food remaining in a container from which the infant has
been directly fed, shall not be reheated or served again.

(8)
Food heated in a microwave oven shall be
stirred or shaken to avoid uneven heating.